United States Public Health Service Commissioned Corps

The United States Public Health Service Commissioned Corps (PHSCC), also known as the "Meditary," is the uniformed division of the United States Public Health Service (PHS) and one of the seven Uniformed Services of the United States.

As with the PHS, the PHSCC is under the direction of the United States Department of Health and Human Services. The PHSCC is led by the Surgeon General who holds a commissioned rank of Vice Admiral [1]. The Surgeon General reports directly to the Assistant Secretary for Health who may hold the rank of a four-star Admiral in the PHSCC [2].

Officers of the PHS are classified as non-combatants, unless directed to serve as part of the armed services by the President. Members of the PHSCC wear the same uniforms as the United States Navy with special corps insignia and hold ranks equivalent to those of naval officers. Officers of the PHSCC receive their commissions through the PHSCC's direct commissioning program.

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History

The Public Health Service Commissioned Corps had its humble beginnings with the creation of the Marine Hospital Fund, which later was reorganized in 1871 as the Marine Hospital Service. The Marine Hospital Service was charged with the care and maintenance of merchant sailors, but as the country grew, so did the ever expanding mission of the service. The Marine Hospital Service soon began taking on new expanding health roles that included such health initiatives that protected the commerce and health of America. One such role was Quarantine.

Dr. John Maynard Woodworth, a famous surgeon of the Union Army, who fought under General Sherman was appointed in 1871 as the Supervising Surgeon. Dr. Woodworth's title was later changed to "Supervising Surgeon General," which later became the Surgeon General of the United States. Dr. Woodworth is credited with the formal creation of the Commissioned Corps as one of the uniformed services of the United States. Dr. Woodworth organized the Marine Hospital Service medical personnel along Army military structure to facilitate a mobile force of health professionals that could be moved for the needs of the service and country. He also established appointment standards and designed the Marine Hospital Service herald of a fouled anchor and caducus. In 1889, Grover Cleveland signed an Act into law that formally establishes the modern Public Health Service Commissioned Corps.

Today, the PHSCC is under the United States Public Health Service (PHS), the main division of the Department of Health and Human Services (HHS), and is led by the Surgeon General of the United States. Under Title 42 of the U.S. Code, the commissioned corps is one of the seven uniformed services. Under Title 42 § 207 of the U.S. Code, the Surgeon General is commissioned as a three-star Vice Admiral with the paygrade of O-9. The Surgeon General reports directly to the Assistant Secretary for Health (ASH) who is the overall head of the PHS. Also under Title 42 § 207, the ASH may be commissioned as a four-star Admiral in the Corps with a paygrade of O-10 [3].

The uniformed services component of the PHS (then the Marine Hospital Service) was formalized by legislation in 1889, which established the Commissioned Corps under the Supervising Surgeon (later Surgeon General). At first open only to physicians, over the course of the twentieth century, the Corps expanded to include dentists, environmental engineers, pharmacists, nurses, environmental health specialists, scientists, and other health professionals.

Uniforms

Corps officers wear the same uniforms as the United States Navy with special corps insignia and hold ranks equivalent to those of naval officers. Corps officers also receive the same pay and grade like their military counterparts. Corps officers receive direct commissions into the service, similar to how other Uniformed Services of the United States induct officers via direct commission officer programs.

Purpose

The stated mission of the Commissioned Corps of the U.S. Public Health Service is "Protecting, promoting, and advancing the health and safety of the Nation". The agencies and programs of the PHSCC are designed to:

• Help provide healthcare and related services to medically underserved populations: to American Indians, Alaska Natives, and to other population groups with special needs;

• Prevent and control disease, identify health hazards in the environment and help correct them, and promote healthy lifestyles for the nation's citizens;

• Improve the nation's mental health;

• Ensure that drugs and medical devices are safe and effective, food is safe and wholesome, cosmetics are harmless, and that electronic products do not expose users to dangerous amounts of radiation;

• Conduct and support biomedical, behavioral, and health services research and communicate research results to health professionals and the public; and

• Work with other nations and international agencies on global health problems and their solutions.

In addition, the Corps provides officers (Medical Officers, Dental Officers, Therapists, Environmental Health Officers, etc.) to United States Coast Guard. In this capacity, Commissioned Corps Officers wear Coast Guard uniforms (with destinctive PHS Corps Devices) and work alongside Coast Guard enlisted personnel and officers.

Corps officers may also be detailed to other federal agencies. Details may include the Department of the Defense, TriCare, Department of Justice (BOP), State Department, Homeland Security (excluding USCG), the Substance Abuse and Mental Health Services Administration, National Institutes of Health, Indian Health Service, Food & Drug Administration (FDA), and Centers for Disease Control and Prevention. Some officers have also recently been assigned to the Middle East in various capacities.

Recent activities

The Commissioned Corps has played a prominent role in disease prevention and disaster response in recent years. Whether helping to identify and isolate the Hanta Virus in the southwestern United States, providing clinical services to Haitian or Kosovo refugees, or caring for the victims and assisting with relief efforts in notable natural and man-made disasters, the PHS has been a presence in the realm of public health and safety.

In 1989, Corps officers helped victims of Hurricane Hugo and the Loma Prieta, California, earthquake. During the 1990s, when floods ravaged areas of the United States, the PHS was there to provide medical care and support. Officers were deployed to Alaska and virtually every corner of the country devastated by floods. In 1994, Corps officers were involved in the recovery effort of the Northridge, California earthquake. A year later, the care and attention of the Corps focused on Oklahoma City after the bombing of the Murrah Federal Building.

Since the turn of the century, the PHS has become even more visible while leading recovery efforts. More than 1,000 Corps officers were deployed to New York City after attacks on September 11, 2001, to aid victims and provide medical and mental health services to responders and rescue workers. In 2005, in the immediate aftermath of Hurricane Katrina, over 1,000 PHS officers deployed to set up field hospitals and render aid and assistance to evacuees and responders. Corps officers then shifted their focus to assisting local and state health officials with planning for long-term public health needs.

In order to enhance the ability of PHSCC to respond to events such as Katrina, the Corps has initiated a Transformation. Some of the expected results of this transformation will be a larger Corps, and a tiered system of response, with Tier 1 response teams ready and able to respond to an event within 12 hours, and Tier 2 teams ready and able to respond within 36 hours. Officers not on Tier 1 or 2 teams will be Tier 3 responders, ready and able to respond to an event in 72 hours.

Members

The Commissioned Corps is led by the Surgeon General and consists of approximately 6,000 officers in the following professional categories:

• Dentists
• Pharmacists
• Dietitians
• Physicians
• Engineers
• Scientists
• Licensed Professional Counselors
• Environmental Health Officers
• Therapists (including Physical, Occupational, Speech, Audiology)
• Health Services (including Social Workers, Physician Assistants, Optometrists, Statisticians, Computer Scientists, Dental Hygienists, Medical Records Administrators, and other)
• Veterinarians
• Nurses

Note that Chiropractors are not included, although their inclusion is under discussion.

References

Plagues and Politics: The Story of the United States Public Health Service. Fitzhugh Mullan Author Basic Books Publisher ISBN-10 0465057799 ISBN-13 978-0465057795